Individual provider Active NPI

Cassie Ann Subbert, LMFT

  • Marriage & Family Therapist
  • Crookston, MN
National Provider Identifier
1083158778
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2794 Issued in MN
Practice address
603 Bruce St
Crookston, MN 56716-2914
Phone
(218) 281-3940
Fax
(218) 281-6261
NPI assigned
Dec 14, 2016
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2794 MN Primary

Addresses

Primary practice location

603 Bruce St
Crookston, MN 56716-2914

Mailing address

603 Bruce St
Crookston, MN 56716-2914
Phone (218) 281-3940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240126003543 MN Practitioner - Marriage and Family Therapist 0749633667 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2794MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Alluma, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

603 Bruce St
Crookston, MN 56716
Phone (218) 281-3940

1422 Central Ave NE
East Grand Forks, MN 56721
Phone (218) 773-6102

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1083158778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBBERT",
        "first_name": "CASSIE",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

Verify at the official NPI Registry.